摘要
目的了解非瓣膜性心房颤动(NVAF)患者左心房血栓(LAT)发生情况,并对LAT的危险因素进行分析。方法选择2016年1月-2020年12月在开封市3所三甲医院(开封市淮河医院、河南大学第一附属医院、开封市人民医院)心内科诊疗的1533例NVAF患者,均行经食管超声心动图(TEE)检查。根据是否并发LAT分为LAT组(n=197)和无LAT组(n=1336)。收集两组患者基础资料、CHA2DS2-VASc评分、生化指标及心功能指标开展单因素分析,进一步通过多因素logistic回归分析探讨NVAF患者LAT的危险因素,并通过绘制受试者工作特征(ROC)曲线判断各危险因素对NVAF患者并发LAT的预测效果。结果1533例NVAF患者中,有197例发生LAT,LAT发生率为12.85%;LAT组脑梗死比例、持续性或永久性房颤比例、CHA2DS2-VASc评分及血小板(PLT)、尿酸、左房内径(LAD)测定值明显高于无LAT组,房颤病程明显长于无LAT组,差异均有统计学意义(P均<0.05)。Logistic回归分析结果显示,房颤病程长、CHA2DS2-VASc评分高、尿酸水平高、LAD扩大为NVAF患者发生LAT的主要危险因素(P<0.05)。ROC曲线分析结果显示,房颤病程、CHA2DS2-VASc评分、尿酸、LAD预测NVAF患者并发LAT的曲线下面积分别为0.763、0.728、0.726、0.722,灵敏度分别为84.30%、62.40%、56.90%、51.80%,特异性分别为56.40%、77.40%、77.80%、82.80%。结论NVAF患者LAT发生率较高,房颤病程长、CHA2DS2-VASc评分高、尿酸水平高、LAD扩大为LAT发生的危险因素,且上述指标可对NVAF患者并发LAT起到一定的预测作用。
Objective To investigate the occurrence of left atrial thrombosis(LAT)in patients with non-valvular atrial fibrillation(NVAF)in Kaifeng,and analyze the risk factors of LAT.Methods A total of 1533 patients with NVAF who were diagnosed and treated in the Cardiology Department of three third-grade class-A hospitals(Huaihe Hospital of Kaifeng City,The First Affiliated Hospital of Henan University and Kaifeng People’s Hospital)from January 2016 to December 2020 were selected.All patients underwent transesophageal echocardiography(TEE).According to whether patients were complicated with LAT,they were divided into LAT group(n=197)and non-LAT group(n=1336).The basic data,CHA2DS2-VASc scores,biochemical indexes and cardiac function indexes of patients in the two groups were collected for univariate analysis;the risk factors of LAT in NVAF patients were further explored through multivariate logistic regression analysis,and the predictive effect of each risk factor on NVAF patients with LAT was judged by drawing receiver operating characteristics(ROC)curve.Results Among 1533 patients with NVAF,197 cases developed LAT,and the incidence of LAT was 12.85%;the proportion of cerebral infarction,proportion of persistent or permanent atrial fibrillation,CHA2DS2-VASc score,measurements of platelet(PLT),uric acid,and left atrial diameter(LAD)in the LAT group were significantly higher than those in the non-LAT group(P<0.05),and the course of atrial fibrillation was significantly longer than that of the non-LAT group(P<0.05).Logistic regression analysis showed that the long course of atrial fibrillation,the high CHA2DS2-VASc score,the high uric acid level,and LAD expansion were the main risk factors for LAT in NVAF patients(P<0.05).ROC curve analysis results showed that the areas under the curve of the course of atrial fibrillation,CHA2DS2-VASc score,uric acid,and LAD predicting LAT in NVAF patients were 0.763,0.728,0.726 and 0.722,respectively,and the sensitivity was 84.30%,62.40%,56.90%and 51.80%,respectively,and the specificity w
作者
王东方
张蕾
王国良
潘庆丽
WANG Dong-fang;ZHANG Lei;WANG Guo-liang;PAN Qing-li(Department of Gardiology,Lankao County Hospital of Traditional Chinese Medicine,Kaifeng,Henan 475300;Huaihe Hospital of Kaifeng City,Kaifeng,Henan 475000;The First Affiliated Hospital of Henan University,Kaifeng,Henan 475000;Kaifeng People's Hospital,Kaifeng,Henan 475000,China)
出处
《热带医学杂志》
CAS
2022年第9期1235-1238,1269,共5页
Journal of Tropical Medicine
基金
河南省医学科技攻关计划项目(2018020314)
关键词
非瓣膜性心房颤动
左心房血栓
危险因素
尿酸
左房内径
Non-valvular atrial fibrillation
Left atrial thrombosis
Risk factors
Uric acid
Left atrial diameter
